Whitening skin can be deadly

By Dr. S. Allen Counter, Globe Correspondent, 12/16/2003

Earlier this year, I was asked by the editor of an international biomedical journal to write a review article on the effects of mercury exposure on children, an area in which I have conducted scientific studies for the past seven years. I was surprised by the results.

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Mexico and Nigeria and the border states of California, Texas and Arizona all show extremely high rates of mercury poisoning.

In clinics in Arizona, for example, doctors had observed more than 300 patients who had toxic levels of mercury in their urine. I found medical reports of similarly high levels of mercury poisoning among patients in Saudi Arabia, Senegal, West Africa, and in Tanzania in East Africa. Even among newly arrived Bosnian and Albanian refugees in Germany, doctors have found patients with toxic levels of this same type of mercury.

One of my first clues to unraveling this mystery turned out to be basic geography: Most of the reported mercury-poisoning cases were found in nations in the lower latitudes.

The second clue: In Mexico, as in other countries such as Saudi Arabia and Pakistan, most of the patients with clinical evidence of mercury poisoning were women. Even in the Southwestern Unites States, 96 percent of the more than 300 patients found to have abnormal mercury levels were female.

In every case, clinical questioning revealed that the women had used skin-whitening creams -- many for years. In other words, these women had tried so desperately to whiten their skin color that they had poisoned their bodies by applying mercury-based "beauty creams."

Ninety percent of the women entering border clinics in Arizona with mercury poisoning were Mexican-American, and they like their Mexican counterparts had been using skin-whitening creams such as "Crema de Belleza-Manning," which is manufactured in Mexico. These skin-whitening creams contain mercurous chloride, which is readily absorbed through the skin. Saudi, African, and Asian women were also using these skin-bleaching chemicals in a tragic attempt to change their appearance to that of white women.

Mercury poisoning is known to cause neurological and kidney damage and may also lead to psychiatric disorders.

Upon finding high levels of mercury in the urine of women and men in Tanzania, scientists initially thought that the indigenous people had been accidentally exposed to elemental mercury vapors from gold mining operations or methylmercury from the consumption of fish from Lake Victoria that had been contaminated by the liquid mercury discharge from gold mines. It was later discovered that the high levels of mercury in the urine of Tanzanians living around Lake Victoria were the result of the use of mercury-based skin-whiteners. In other parts of Africa, including Nigeria and Kenya, one finds widespread mercury poisoning from the use of skin-lightening creams and soaps.

When asked why she thought women in Saudi Arabia used skin-whitening creams, and in some cases even applied these creams to their children, one woman from an Arab-American family replied directly, "Oh, that's simple. It is well known that in many Arab families the whiter looking children are the most preferred. People will often respond positively to the lighter-colored child and simply ignore the darker one."

So, the prevalent medical evidence of high levels of mercury poisoning among women of Saudi, African, Asian and Mexican backgrounds reflects a common and prevailing belief that whiter skin has greater currency and appeal.

Apparently, the patients reporting to clinics with mercury-induced disease believe that the health risks associated with bleaching their skins are outweighed by the rewarding sociocultural return. In other words, they believe that removing the healthy melanin from their skin with toxic creams and soaps makes them more valuable in their own cultures and in European and Euro-American societies in general.

In an interview with one Latin American woman about identification and self-image, I was told that "whiter-looking Spanish women are generally perceived as more attractive to many Latino men and vice versa." The woman, a journalist, went on to say that during her childhood, her parents and her friends' parents had always carefully screened the children invited to their parties "to be certain that they were light enough in color" and thus "of sufficient socioeconomic value to be included."

While one might accept skin-bleaching among adults as an unfortunate matter of personal choice, albeit an ignorant one, the use of such skin-lightening creams on children is unconscionable. The developing nervous system of children is particularly vulnerable to toxic mercury exposure and other vital organs are also susceptible. In one medical report, a 3-month-old patient was found to have kidney, eye and blood disease because the mother had used mercury-containing cosmetics during pregnancy and later during breast-feeding.

Most women and men we interviewed seemed to have some inkling that they were taking a chance to make themselves look whiter, but it's unfair to say they knew the true risks.

Science has not yet revealed how quickly skin-whitening cream will lead to health problems, though many say women see impacts just a few weeks after they begin applying it. It is imperative that we educate people throughout the world about the hazards of mercury exposure, particularly the risks associated with skin-bleaching cosmetics.

Perhaps we must make an equally strong effort to convince women and men of color that they are beautiful as they are. This task, however, may be as challenging as trying to convince people with light skin that it is unnecessary -- and hazardous to lie out in the sun or go to a salon in pursuit of a tan.

Dr. S. Allen Counter is a professor of neurophysiology and neurology at Harvard Medical School.